ANATOMIC DRAWINGS OF THE BRAIN AND CENTRAL NERVOUS SYSTEM Cerebral cortex C T H C = Corpus collosum H = Hypothalamus Pons T = Thalamus Medulla Cerebellum Spinal cord SAGITTAL CUT THROUGH THE BRAIN AND BRAIN STEM SEER Summary Staging Manual - 2000 263 ANATOMIC DRAWINGS OF THE BRAIN AND CENTRAL NERVOUS SYSTEM 2 1 3 4 7 5 8 6 SAGITTAL CUT THROUGH THE HUMAN HEAD WITH CEREBRUM IN PLACE The cerebrum is comprised of the: 1 Frontal lobe 2 Parietal lobe 3 Temporal lobe 4 Occipital lobe Other parts of the brain include: 5 Pons 6 Medulla (oblongata) 7 Cerebellum 8 Tentorium (cerebelli) 264 SEER Summary Staging Manual - 2000 ANATOMIC DRAWINGS OF THE BRAIN AND CENTRAL NERVOUS SYSTEM A B C D E 7 5 6 8 F SAGITTAL CUT THROUGH THE HUMAN HEAD Internal anatomy of the brain: A Inner surface of right hemisphere of cerebrum B Corpus callosum C Velum interpositum D Middle commissure E Third ventricle F Fourth ventricle Other parts of the brain (as on previous drawing): 5 Pons 6 Medulla (oblongata) 7 Cerebellum 8 Tentorium (cerebelli) SEER Summary Staging Manual - 2000 265 BRAIN AND CEREBRAL MENINGES C70.0, C71.0-C71.9 Supratentorial (S) or Infratentorial (I) C70.0 Cerebral meninges C71.0 Cerebrum ? (S) C71.1 Frontal lobe (S) C71.2 Temporal lobe (S) C71.3 Parietal lobe (S) C71.4 Occipital lobe (S) C71.5 Ventricle, NOS (S) C71.6 Cerebellum, NOS (I) C71.7 Brain stem (I) C71.8 Overlapping lesion of brain ? C71.9 Brain, NOS ? ?See Note 1. SUMMARY STAGE 1 Localized only Supratentorial tumor confined to: Cerebral hemisphere (cerebrum) or meninges of cerebral hemisphere on one side: Frontal lobe Occipital lobe Parietal lobe Temporal lobe More than one lobe in same hemisphere Infratentorial tumor confined to: Cerebellum or meninges of cerebellum on one side: Vermis: Lateral lobes Median lobe of cerebellum Brain stem or meninges of brain stem on one side: Medulla oblongata Midbrain (mesencephalon) Pons Both cerebellum and brain stem involved WITH tumor on one side Hypothalamus Thalamus Confined to brain, NOS Confined to meninges, NOS Confined to ventricles Tumor invades or encroaches upon ventricular system 266 SEER Summary Staging Manual - 2000 BRAIN AND CEREBRAL MENINGES C70.0, C71.0-C71.9 5 Regional, NOS Infratentorial tumor extends supratentorially to involve cerebrum (cerebral hemisphere) Supratentorial tumor extends infratentorially to involve cerebellum or brain stem Tumor crosses the midline Tumor invades: Bone (skull) Major blood vessel(s) Meninges (dura) Nerves, NOS: Cranial nerves Spinal cord/canal Tumor involves contralateral hemisphere Tumor involves corpus callosum including splenium. 7 Distant site(s)/lymph node(s) involved Distant lymph node(s) Extension to: Nasal cavity Nasopharynx Posterior pharynx Outside central nervous system (CNS) Circulating cells in cerebral spinal fluid (CSF) Further contiguous extension Metastasis: “Drop” metastasis 9 Unknown if extension or metastasis Note: Codes 0, 2, 3, and 4 are not applicable for this scheme. Note 1: The following subsites coded to C71.0 are INFRAtentorial: hypothalamus, pallium, thalamus. The following subsites coded to C71.8 are SUPRAtentorial: corpus callosum, tapetum. The following sites coded to C71.9 are SUPRAtentorial: anterior cranial fossa, middle cranial fossa, suprasellar; the following subsites coded to C71.9 are INFRAtentorial: posterior cranial fossa. Note 2: This scheme is compatible with the AJCC Cancer Staging Manual, Fourth Edition for brain. The AJCC opted not to recommend a TNM scheme for brain in the fifth edition. SEER Summary Staging Manual - 2000 267 OTHER PARTS OF CENTRAL NERVOUS SYSTEM C70.1, C70.9, C72.0-C72.5, C72.8-C72.9 C70.1 Spinal meninges C70.9 Meninges, NOS C72.0 Spinal cord C72.1 Cauda equina C72.2 Olfactory nerve C72.3 Optic nerve C72.4 Acoustic nerve C72.5 Cranial nerve, NOS C72.8 Overlapping lesion of brain and central nervous system C72.9 Nervous system, NOS SUMMARY STAGE 1 Localized only Tumor confined to tissue or site of origin Localized, NOS 5 Regional, NOS Adjacent connective/soft tissue Adjacent muscle Brain for cranial nerve tumors Major blood vessel(s) Meningeal tumor infiltrates nerve Nerve tumor infiltrates meninges (dura) Sphenoid and frontal sinuses (skull) 7 Distant site(s)/lymph node(s) involved Distant lymph node(s) Bone other than skull Brain except for cranial nerve tumors Eye Further contiguous extension Metastasis 9 Unknown if extension or metastasis Note: Codes 0, 2, 3, and 4 are not applicable for this scheme. 268 SEER Summary Staging Manual - 2000.